Cognitive Test Performance in Relation to Health and Function in 12 European Countries: The SHARE Study

BACKGROUND Even subtle impairments on cognitive test scores can be associated with future cognitive decline and dementia. We assayed the relationships between test score impairment and adverse outcomes. METHODS Secondary analyses were performed on data from non-institutionalized participants, 50+ years of age (N = 30,038), from 12 countries taking part in the Survey of Health, Ageing and Retirement in Europe (SHARE) longitudinal study on aging. At baseline, participants' cognition was tested using verbal fluency, immediate recall, and delayed recall tasks. RESULTS Greater levels of cognitive impairment at baseline were strongly associated with future poor health outcomes and functional impairment. Controlling for age, sex and education, those with 1 (OR = 1.58, 95% CI = 1.34-1.87) or ≥ 2 (OR = 2.59, 95% CI = 2.17-3.09) impaired tests at baseline were more likely to die after an average of 40 months compared to individuals with no impairments. After selecting for participants who reported the absence of dementia initially, those with ≥ 2 cognitive impairments at baseline (OR = 3.34, 95% CI = 2.27-4.92) were more likely to report dementia at follow-up compared to those with no impairment. CONCLUSIONS People with impaired cognitive test scores at baseline are at greater risk to die or develop dementia within four years than their less impaired or unimpaired counterparts.